| NPI | 1083122501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 00001887) |
| 106S00000X Behavior Technician (Licence: CA RBT-17-39773) | |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2023-04-05 |